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Introductory Clinical Pharmacology

Chapter 8Cephalosporins

Introductory Clinical Pharmacology

Chapter 8Cephalosporins

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IntroductionIntroduction

• Effective in the treatment of all strains of bacteria affected by penicillins and some strains resistant to penicillins

• Classification: Divided into first-, second-, third-, and fourth-generation drugs

• Uses: Treat urinary tract infections; skin infections; hospital-acquired pneumonias

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Examples of CephalosporinsExamples of Cephalosporins

• Keflex / cephalexin

• Ancef / cefazolin

• Ceclor / cefaclor

• Rocephin / ceftriaxone

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Cephalosporins: ActionsCephalosporins: Actions• Exert bactericidal

effect

•Targets the bacterial cell wall, making it defective and unstable

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Cephalosporins: UsesCephalosporins: Uses

• Used to treat infections caused by bacteria

– Respiratory

– Ear

– Bone/joint

– Genitourinary tract infections

• Culture and sensitivity tests: Help determine best antibiotic to control an infection

• Used throughout perioperative period

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Cephalosporins: Adverse ReactionsCephalosporins: Adverse Reactions

• Gastrointestinal reactions

– Nausea; vomiting; diarrhea

• Administration route reactions

– Intramuscularly; intravenously

– Pain at site of injection/infusion

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• Other body system reactions

– Headache; dizziness; malaise; heartburn; fever; nephrotoxicity; hypersensitivity; aplastic anemia; toxic epidermal necrolysis

– Nursing alert

•Allergy: Approximately 10% of people allergic to penicillin are also allergic to cephalosporins

Cephalosporins: Adverse Reactions (cont’d)Cephalosporins: Adverse Reactions (cont’d)

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Cephalosporins: Contraindications and PrecautionsCephalosporins: Contraindications and Precautions

• Contraindicated in patients allergic to cephalosporins or penicillins

• Used cautiously in patients with:

– Renal disease; hepatic impairment; pregnancy (Category B); known penicillin allergy

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Cephalosporins: Interactions Cephalosporins: Interactions

Drug Common use Effect of interaction

Aminoglycosides

Anti-infective Increased risk for nephrotoxicity

Oral anticoagulants

Blood thinner Increased risk for bleeding

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Nursing Process: AssessmentNursing Process: Assessment

• Preadministration assessment

– Obtain general health history before first dose

– Check for need of cultures and sensitivity tests

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Nursing Process: Assessment (cont’d)Nursing Process: Assessment (cont’d)

• Ongoing assessment

– Evaluate response to therapy

– If infection worsens, notify primary health care provider

– Check for signs and symptoms of infection

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• Educating the patient and family

– Review dosage regimen with the patient and family

– Advise to complete full therapy and adhere to timing

– Explain to shake oral suspensions and keep refrigerated

– Advise to avoid alcohol and take with food if GI upset

Nursing Process: ImplementationNursing Process: Implementation

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Nursing Process: EvaluationNursing Process: Evaluation

• Therapeutic effect achieved

• Urine output at least 500 mL daily; diarrhea not experienced

• Patient and family demonstrate understanding of drug regimen

• Patient verbalizes importance of compliance with prescribed therapeutic regimen

• Skin is free of inflammation, irritation, or ulcerations

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End of Presentation